Objective To discuss the feasibility, safety and validity of the use of ViabahnTM self-expanding covered stent in endovascular repair of peripheral traumatic pseudoaneurysm (TPA). Methods During the period from June 2012 to April 2014, a total of 8 patients with peripheral TPA were admitted to the Department of Vascular and Endovascular Surgery of Shanghai Changzheng Hospital . The clinical data were retrospective analyzed. The lesions were located at the common carotid artery (n=4), vertebral artery (n=1), subclavian artery (n=1) and superficial femoral artery (n=2). On the basis of acute and chronic TPA classification and different therapeutic principles, endovascular repair with ViabahnTM self-expanding covered stent was employed in 8 patients. Intraoperative angiographic findings, the size and number of the implanted stent, and the immediate angiographic results after stent implantation were recorded. All the patients were followed up to evaluate the improvement of the symptoms, the effectiveness of the repair of TPA cavity, and the occurrence of endoleak or restenosis. Results Successful implantation of ViabahnTM self-expanding covered stent was accomplished in all 8 patients, with a technical success rate of 100%. Angiography performed immediately after stent implantation showed that complete repair of TPA cavity was obtained in all patients, the distal segment of the parent artery was patent, and no endoleak was observed. The sizes of the stent used in the patients were 8×50 mm (n=2) and 9×50 mm (n=2) in common carotid artery, 6×50 mm (n=1) in vertebral artery, 11×100 mm (n=1) in subclavian artery, and 8×100 mm (n=2) in superficial femoral artery. The patients were followed up for 6-30 months (mean of 14.3 months), and the clinical symptoms disappeared in all patients. CT angiography indicated that there was no endoleak or restenosis. Conclusion Based on the different therapeutic principles, the use of ViabahnTM self-expanding covered stent in endovascular repair of peripheral TPA is technically simple and micro-invasive, and clinically feasible with reliable effect and safety. Therefore, this technique can be employed as a first-line therapy option for peripheral TPA.

Objective: To analysis the pathogenic mutation and the clinical characteristics of a three generation family with congenital pulverulent cataract. Methods: A congenital cataract family was chosen from the First Affiliated Hospital of AnHui Medical University, 5 ml peripheral blood was obtained from each family member to extract genomic DNA.Next generation sequencing was used to detect the mutation in proband (Ⅱ5), Ⅱ6 and Ⅲ8, and Sanger sequencing was applied to verify pathogenic mutation in the whole family members.The mutation site was compared with the gene sequence of 10 000 normal Chinese.PolyPhen-2 and SIFT were applied to analysis the alteration on the protein structure and function and its possible pathogenesis.This study followed the Declaration of Helsinki and was approved by the Ethics Committee of AnHui Medical University (NO.PJ2017-5-17). All patients signed informed consent. Results: The pedigree consisted of 19 members of three generations, including 10 patients and 9 normal family members.Heterozygous mutation of GJA3 gene c. 427G>A (p.G143R) was detected in all patients of the pedigree, but was not found in normal members of the pedigree and 10 000 normal Chinese.The score calculated from SIFT and PolyPhen-2 indicated that the mutation probably had malignant effect on normal protein structure, Swiss-model website analysis showed that the mutation likely altered the secondary structure of the protein CX 46 by reducing an α-helix between 107-115 amino acids.Meanwhile, c.1325-1G>T mutation of HSF4 gene were detected in Ⅱ5 and Ⅲ8, which was not found in other family members and 10 000 normal Chinese.HSF and MaxEntScan results showed that the mutation probably had serious effect on the splicing of mRNA.The cataract development rates of Ⅱ5 and Ⅲ8 were faster than that of the same age in the same generation of the pedigree, and the morphology of lens opacity was changed. Conclusions The heterozygous c. 427G>A mutation in GJA3 gene is responsible for pulverulent cataract in this family, meanwhile the c. 1325-1G>T mutation in HSF4 gene may change the type of phacoscotasmus and accelerate the progress of disease.

Arrhythmias are complications of tunneled cuffed hemodialysis catheter insertion. Most complications associated with arrhythmias occur during guide-wire access, where the guide wire can cause traumatic damage to the conduction system of the heart. Conducting system injury in tunneled cuffed hemodialysis catheter insertion often involves the right bundle, causing right bundle branch block (RBBB). Transient RBBB with sinus rhythm is not usually accompanied by abnormal vital signs. However if patients already have left bundle branch block (LBBB), new onset RBBB can cause complete atrioventricular block (AVB), which can lead to fatal complications requiring invasive treatment. We report on a patient with LBBB who developed complete AVB during hemodialysis catheter insertion.
Arrhythmias, Cardiac ; Atrioventricular Block* ; Bundle-Branch Block* ; Catheters* ; Heart ; Humans ; Renal Dialysis* ; Vital Signs